The super El Niño poses severe risks to water security, agriculture, and public health in Asia's largest cities. Drought-prone cities like Jakarta and Mumbai may face prolonged dry spells, threatening water supplies and food production. Conversely, cities like Shanghai and Colombo could experience extreme flooding, leading to water contamination and disease outbreaks. The event also threatens global agricultural output, with potential losses of up to $342 billion, impacting food security for millions, particularly smallholder farmers.